Evolving hypopituitarism as a consequence of traumatic brain injury (TBI) in childhood—call for attention

Abstract

Hypopituitarism is a common complication of TBI in long-term survivors, more frequent than previously realized. It may be partial or complete, sometimes very subtle without visible lesions in hypothalamo-pituitary region and is diagnosed only by biochemical means. Neuroendocrine abnormalities caused by TBI may have significant implications for the recovery and rehabilitation of these patients. The subjects at risk are those who have suffered moderate to severe trauma, although mild intensity trauma may precede hypopituitarism also. Particular attention should be paid to this problem in children and adolescents. We describe a patient with hypopituitarism thought to be idiopathic due to mild head trauma which caused diabetes insipidus in childhood, gradual failure of pituitary hormones during the period of growth and development, and metabolic (dyslipidemia), physical (obesity), and cognitive impairments in the adult period.

Update of Endocrine Dysfunction following Pediatric Traumatic Brain Injury

“…Cross-sectional studies documented 16%–61% prevalence of hypopituitarism at 1–5 years after injury [ 23 , 34 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ]. A number of reviews and commentaries have discussed the need for prospective studies of hypothalamic-pituitary function after TBI in children [ 44 , 45 , 46 ]. To date, only four prospective studies in the pediatric age group have been published regarding endocrine abnormalities after TBI [ 34 , 47 , 48 , 49 ].…”